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1.
SSM Popul Health ; 15: 100900, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34485674

RESUMO

Despite a myriad of potential pathways linking neighborhood change and gentrification to health, existing quantitative measures failed to capture individual-level, self-reported perceptions of these processes. We developed the Perceptions About Change in Environment and Residents (PACER) survey to measure the gentrification-related neighborhood change experienced by individuals relevant to health. We employed a multi-stage process to develop PACER including a scoping review, question refinement, content validity, and cognitive interviews. Content validity and cognitive interviews were assessed within the National Neighborhood Indicators Partnership (NNIP) and for residents of different tenure in both gentrifying and non-gentrifying neighborhoods to ensure PACER considers the complex nature of neighborhood change for different people within different urban contexts. We piloted the instrument to a sample from the resident panel BeHeardPhilly to assess acceptability and data quality. Finally, we assessed internal consistency, dimensionality, and criterion-related validity using Principal Components Analysis (PCA), descriptive statistics, and correlation coefficients. Testing showed good internal consistency for PACER questions, as well as for each of four resulting factors (Feelings, Built Environment, Social Environment, and Affordability). Correlations between factors and other context measures demonstrated strong criterion-related validity. PACER offers an unprecedented tool for measuring and understanding resident perceptions about gentrification-related neighborhood change relevant to health. Rigorously tested and tailored for health, PACER holds utility for application across different settings to examine changes from events that may impact and shift neighborhoods.

2.
Artigo em Inglês | MEDLINE | ID: mdl-34360264

RESUMO

Few studies have examined associations between neighborhood built environments (BE) and longitudinally measured cognition. We examined whether four BE characteristics were associated with six-year change in global cognition and processing speed. We obtained data on 1816 participants without dementia from the Multi-Ethnic Study of Atherosclerosis. BE measures included social destination density, walking destination density, proportion of land dedicated to retail, and network ratio (street connectivity). Global cognition was measured with the Cognitive Abilities Screening Instrument (CASI) and processing speed with the Digit Symbol Coding test (DSC). Multivariable random intercept logistic models tested associations between neighborhood BE at 2010-2012 and maintained/improved cognition (versus decline) from 2010-2018, and mediation by minutes of physical activity (PA)/week. The sample was an average of 67 years old (standard deviation = 8.2) (first cognitive measurement) and racially/ethnically diverse (29% African American, 11% Chinese, 17% Hispanic, 44% White). Compared to individuals with no walking destinations in the 1-mile surrounding their residence, those with 716 walking destinations (maximum observed) were 1.24 times more likely to have maintain/improved DSC score (Odds ratio: 1.24; 95% confidence interval: 1.03-1.45). No other associations were observed between BE and cognition, and PA minutes/week did not mediate the association between walking destination density and DSC change. This study provides limited evidence for an association between greater neighborhood walking destinations and maintained/improved processing speed in older age and no evidence for associations between the other BE characteristics and cognition. Future studies with finer grained BE and cognitive measures and longer-term follow up may be required.


Assuntos
Aterosclerose , Ambiente Construído , Idoso , Cognição , Estudos Transversais , Planejamento Ambiental , Humanos , Características de Residência , Caminhada
3.
BMJ Open ; 11(7): e048390, 2021 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-34244272

RESUMO

OBJECTIVES: We investigated the association of healthy food retail presence and cardiovascular mortality, controlling for sociodemographic characteristics. This association could inform efforts to preserve or increase local supermarkets or produce market availability. DESIGN: Cohort study, combining Mortality Disparities in American Communities (individual-level data from 2008 American Community Survey linked to National Death Index records from 2008 to 2015) and retail establishment data. SETTING: Across the continental US area-based sociodemographic and retail characteristics were linked to residential location by ZIP code tabulation area (ZCTA). Sensitivity analyses used census tracts instead, restricted to urbanicity or county-based strata, or accounted for non-independence using frailty models. PARTICIPANTS: 2 753 000 individuals age 25+ living in households with full kitchen facilities, excluding group quarters. PRIMARY AND SECONDARY OUTCOME MEASURES: Cardiovascular mortality (primary) and all-cause mortality (secondary). RESULTS: 82% had healthy food retail (supermarket, produce market) within their ZCTA. Density of such retail was correlated with density of unhealthy food sources (eg, fast food, convenience store). Healthy food retail presence was not associated with reduced cardiovascular (HR: 1.03; 95% CI 1.00 to 1.07) or all-cause mortality (HR: 1.05; 95% CI 1.04 to 1.06) in fully adjusted models (with adjustment for gender, age, marital status, nativity, Black race, Hispanic ethnicity, educational attainment, income, median household income, population density, walkable destination density). The null finding for cardiovascular mortality was consistent across adjustment strategies including minimally adjusted models (individual demographics only), sensitivity analyses related to setting, and across gender or household type strata. However, unhealthy food retail presence was associated with elevated all-cause mortality (HR: 1.15; 95% CI 1.11 to 1.20). CONCLUSIONS: In this study using food establishment locations within administrative areas across the USA, the hypothesised association of healthy food retail availability with reduced cardiovascular mortality was not supported; an association of unhealthy food retail presence with higher mortality was not specific to cardiovascular causes.


Assuntos
Doenças Cardiovasculares , Características de Residência , Adulto , Estudos de Coortes , Comércio , Fast Foods , Humanos , Estados Unidos/epidemiologia
4.
Health Place ; 70: 102596, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34091144

RESUMO

We determined associations of cumulative exposures to neighborhood physical activity opportunities with risk of incident cardiovascular disease (CVD). We included 3595 participants from the Cardiovascular Health Study recruited between 1989 and 1993 (mean age = 73; 60% women; 11% black). Neighborhood environment measures were calculated using Geographic Information Systems (GIS) and annual information from the National Establishment Time Series database, including the density of (1) walking destinations and (2) physical activity/recreational facilities in a 1- and 5-km radius around the respondent's home. Incident CVD was defined as the development of myocardial infarction, stroke, or cardiovascular death and associations with time to incident CVD were estimated using Cox proportional hazards models. A total of 1986 incident CVD cases occurred over a median follow-up of 11.2 years. After adjusting for baseline and time-varying individual and neighborhood-level confounding, a one standard deviation increase in walking destinations and physical activity/recreational facilities within 5 km of home was associated with a respective 7% (95% confidence interval (CI) = 0.87-0.99) and 12% (95% CI = 0.73-1.0) decreased risk of incident CVD. No significant associations were noted within a 1-km radius. Efforts to improve the availability of physical activity resources in neighborhoods may be an important strategy for lowering CVD.

5.
Prev Chronic Dis ; 18: E48, 2021 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-33988496

RESUMO

INTRODUCTION: Profound geographic disparities in health exist in many US cities. Most reporting on these disparities is based on predetermined administrative districts that may not reflect true neighborhoods. We undertook a ranking project to describe health at the neighborhood level and used Philadelphia, Pennsylvania, as our case study. METHODS: To create neighborhood health rankings, we first divided the city into neighborhoods according to groups of contiguous census tracts. Modeling our ranking methods and indicators on the Robert Wood Johnson Foundation County Health Rankings, we gathered census tract-level data from the Centers for Disease Control and Prevention's 500 Cities Project and local sources and aggregated these data, as needed, to each neighborhood. We assigned composite scores and rankings for both health outcomes and health factors to each neighborhood. RESULTS: Scores for health outcomes and health factors were highly correlated. We found clusters of neighborhoods with low rankings in Philadelphia's northern, lower northeastern, western, and southwestern regions. We disseminated information on rankings throughout the city, including through a comprehensive webpage, public communication, and a museum exhibit. CONCLUSION: The Philadelphia neighborhood health rankings were designed to be accessible to people unfamiliar with public health, facilitating education on drivers of health in communities. Our methods can be used as a model for other cities to create and communicate data on within-city geographic health disparities.


Assuntos
Saúde Pública , Características de Residência , População Urbana , Cidades , Humanos , Philadelphia , Saúde Pública/estatística & dados numéricos , Fatores Socioeconômicos
6.
J Alzheimers Dis ; 82(1): 221-233, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34024841

RESUMO

BACKGROUND: Preliminary evidence suggests associations between neighborhood park access and better late-life cognition and reduced Alzheimer's disease (AD) risk. OBJECTIVE: Examine associations between neighborhood park access and longitudinal change in cognition among U.S. older adults without dementia. METHODS: We used 2000-2018 observational data from the population-based, multi-site Multi-Ethnic Study of Atherosclerosis (n = 1,733). Measures included proportion of neighborhood park space (park access), distance to nearest park, and 6-year dichotomous and continuous change in scores on the Cognitive Abilities Screening Instrument (CASI; global cognition) and Digit Symbol Coding task (processing speed). Multivariable random intercept models tested main associations and mediation by depressive symptoms, physical activity, and PM2.5 exposure. Effect modification by race (African Americans/Blacks versus Whites) was tested using interaction terms. RESULTS: Greater park access (equivalent to 10%more in 1/2-mile around home) was associated with maintained/improved CASI score over six years independent of several covariates including individual- and neighborhood-level socioeconomic status (Odds ratio: 1.04; 95%confidence interval: 1.00-1.08). No other associations were observed with the dichotomous or continuous measures of cognitive change and no mediators were found. While a borderline association was seen between greater park access and maintained/improved CASI for African Americans/Blacks but not for Whites, effect modification was not confirmed by testing interaction terms. CONCLUSION: Neighborhood park access may help maintain/improve late-life global cognition. However, our findings need replication in other population-based studies and regions. Additionally, studies are needed to determine if associations between park access and change in cognition vary by race/ethnicity to inform intervention efforts.


Assuntos
Cognição/fisiologia , Grupos Étnicos/estatística & dados numéricos , Parques Recreativos , Características de Residência , Idoso , Exercício Físico/fisiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Estados Unidos
7.
Artigo em Inglês | MEDLINE | ID: mdl-33806987

RESUMO

Neighborhood greenspace may attract new residents and lead to sociodemographic or housing cost changes. We estimated relationships between greenspace and gentrification-related changes in the 43 largest metropolitan statistical areas (MSAs) of the United States (US). We used the US National Land Cover and Brown University Longitudinal Tracts databases, as well as spatial lag models, to estimate census tract-level associations between percentage greenspace (years 1990, 2000) and subsequent changes (1990-2000, 2000-2010) in percentage college-educated, percentage working professional jobs, race/ethnic composition, household income, percentage living in poverty, household rent, and home value. We also investigated effect modification by racial/ethnic composition. We ran models for each MSA and time period and used random-effects meta-analyses to derive summary estimates for each period. Estimates were modest in magnitude and heterogeneous across MSAs. After adjusting for census-tract level population density in 1990, compared to tracts with low percentage greenspace in 1992 (defined as ≤50th percentile of the MSA-specific distribution in 1992), those with high percentage greenspace (defined as >75th percentile of the MSA-specific distribution) experienced higher 1990-2000 increases in percentage of the employed civilian aged 16+ population working professional jobs (ß: 0.18, 95% confidence interval (CI): 0.11, 0.26) and in median household income (ß: 0.23, 95% CI: 0.15, 0.31). Adjusted estimates for the 2000-2010 period were near the null. We did not observe evidence of effect modification by race/ethnic composition. We observed evidence of modest associations between greenspace and gentrification trends. Further research is needed to explore reasons for heterogeneity and to quantify health implications.


Assuntos
Habitação , Parques Recreativos , Adolescente , Grupos Étnicos , Humanos , Densidade Demográfica , Características de Residência , Estados Unidos
8.
Int J Health Geogr ; 20(1): 15, 2021 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-33766045

RESUMO

BACKGROUND: Although neighborhood-level access to food differs by sociodemographic factors, a majority of research on neighborhoods and food access has used a single construct of neighborhood context, such as income or race. Therefore, the many interrelated built environment and sociodemographic characteristics of neighborhoods obscure relationships between neighborhood factors and food access. METHODS: The objective of this study was to account for the many interrelated characteristics of food-related neighborhood environments and examine the association between neighborhood type and relative availability of sit-down restaurants and supermarkets. Using cluster analyses with multiple measures of neighborhood characteristics (e.g., population density, mix of land use, and sociodemographic factors) we identified six neighborhood types in 1993 in the Twin Cities Region, Minnesota. We then used mixed effects regression models to estimate differences in the relative availability of sit-down restaurants and supermarkets in 1993, 2001, and 2011 across the six neighborhood types. RESULTS: We defined six types of neighborhoods that existed in 1993, namely, urban core, inner city, urban, aging suburb, high-income suburb, and suburban edge. Between 1993 and 2011, inner city neighborhoods experienced a greater increase in the percent of sit-down restaurants compared with urban core, urban, and aging suburbs. Differences in the percent of sit-down restaurants between inner city and aging suburbs, high-income suburbs and suburban edge neighborhoods increased between 1993 and 2011. Similarly, aging suburb neighborhoods had a greater percent of supermarkets compared with urban and high-income suburb neighborhoods in 2001 and 2011, but not in 1993, suggesting a more varied distribution of food stores across neighborhoods over time. Thus, the classification of neighborhood type based on sociodemographic and built environment characteristics resulted in a complex and increasingly varied distribution of restaurants and food stores. CONCLUSIONS: The temporal increase in the relative availability of sit-down restaurants in inner cities after accounting for all restaurants might be partly related to a higher proportion of residents who eat-away-from-home, which is associated with higher calorie and fat intake.


Assuntos
Restaurantes , Supermercados , Cidades , Abastecimento de Alimentos , Humanos , Características de Residência
9.
Soc Psychiatry Psychiatr Epidemiol ; 56(9): 1575-1585, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33388800

RESUMO

PURPOSE: Greater neighborhood greenspace has been associated with brain health, including better cognition and lower odds of Alzheimer's disease in older adults. We investigated associations between neighborhood greenspace and brain-based magnetic resonance imaging (MRI) measures and potential effect modification by sex or apolipoprotein E genotype (APOE), a risk factor for Alzheimer's disease. METHODS: We obtained a sample of non-demented participants 65 years or older (n = 1125) from the longitudinal, population-based Cardiovascular Health Study (CHS). Greenspace data were derived from the National Land Cover Dataset. Adjusted multivariable linear regression estimated associations between neighborhood greenspace five years prior to the MRI and left and right hippocampal volume and 10-point grades of ventricular size and burden of white matter hyperintensity. Interaction terms tested effect modification by APOE genotype and sex. CHS data (1989-1999) were obtained/analyzed in 2020. RESULTS: Participants were on average 79 years old [standard deviation (SD) = 4], 58% were female, and 11% were non-white race. Mean neighborhood greenspace was 38% (SD = 28%). Greater proportion of greenspace in the neighborhood five years before MRI was borderline associated with lower ventricle grade (estimate: - 0.30; 95% confidence interval: - 0.61, 0.00). We observed no associations between greenspace and the other MRI outcome measures and no evidence of effect modification by APOE genotype and sex. CONCLUSION: This study suggests a possible association between greater greenspace and less ventricular enlargement, a measure reflecting global brain atrophy. If confirmed in other longitudinal cohort studies, interventions and policies to improve community greenspaces may help to maintain brain health in older age.


Assuntos
Parques Recreativos , Características de Residência , Idoso , Encéfalo/diagnóstico por imagem , Feminino , Humanos , Estudos Longitudinais , Neuroimagem
10.
Artigo em Inglês | MEDLINE | ID: mdl-33494425

RESUMO

While studies have documented the influence of caregiver and care recipient factors on caregiver health, it is important to address the potential impact of neighborhood contexts. This study estimated the cross-sectional associations between neighborhood characteristics and mental health among caregivers cohabiting with Alzheimer's disease care recipients that were experiencing severe or non-severe neuropsychiatric symptoms (NPSs) (e.g., aggression/anxiety). We obtained data collected in 2010 on caregivers and care recipients (n = 212) from a subset of South Carolina's Alzheimer's Disease Registry. Neighborhood measures (within 1 mile of the residence) came from the American Community Survey and the Rural-Urban Commuting Area Code. We categorized the neighborhood median household income into tertiles, namely, "low" (<$31,000), "medium" ($31,000-40,758), and "high" (>$40,758), and rurality as "large urban," "small urban," and "rural." We used negative binomial regression to estimate the prevalence ratios (PRs) and 95% confidence intervals (CIs) for caregiver mental health using neighborhood characteristics. The mean age was 58 ± 10.3 years, 85% were women, and 55% were non-Hispanic Black. Among the caregivers cohabiting with a recipient experiencing severe NPS, higher distress was experienced by caregivers living in low- (PR = 1.61 (95% CI = 1.26-2.04)) and medium- (PR = 1.45 (95% CI = 1.17-1.78)) vs. high-income neighborhoods after an adjustment. These results suggest that neighborhood characteristics may amplify other social stressors experienced by caregivers.


Assuntos
Doença de Alzheimer , Cuidadores , Idoso , Doença de Alzheimer/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Características de Residência
11.
J Urban Health ; 98(2): 271-284, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33005987

RESUMO

Retail environments, such as healthcare locations, food stores, and recreation facilities, may be relevant to many health behaviors and outcomes. However, minimal guidance on how to collect, process, aggregate, and link these data results in inconsistent or incomplete measurement that can introduce misclassification bias and limit replication of existing research. We describe the following steps to leverage business data for longitudinal neighborhood health research: re-geolocating establishment addresses, preliminary classification using standard industrial codes, systematic checks to refine classifications, incorporation and integration of complementary data sources, documentation of a flexible hierarchical classification system and variable naming conventions, and linking to neighborhoods and participant residences. We show results of this classification from a dataset of locations (over 77 million establishment locations) across the contiguous U.S. from 1990 to 2014. By incorporating complementary data sources, through manual spot checks in Google StreetView and word and name searches, we enhanced a basic classification using only standard industrial codes. Ultimately, providing these enhanced longitudinal data and supplying detailed methods for researchers to replicate our work promotes consistency, replicability, and new opportunities in neighborhood health research.


Assuntos
Comércio , Características de Residência , Meio Ambiente , Comportamentos Relacionados com a Saúde , Humanos
12.
J Aging Health ; 33(3-4): 227-236, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33251918

RESUMO

Objectives: Aging in place (residential stability) is a desirable means of aging where adults remain in their homes, even when facing challenges that impair their capacity for self-care. Residential stability, especially following acute health challenges, depends on individual and community factors, possibly including proximity to medical facilities. Methods: We explored the association between the density of medical facilities around homes with risk of incident myocardial infarction (MI) and with aging in place following incident MI. Results: Densities of neighborhood pharmacies were not associated with aging in place or time to MI. High densities of neighborhood clinical care facilities were significantly associated with decreased residential stability. Discussion: The lack of significant associations between medical facility exposures and MI-related outcomes, coupled with prior findings, casts doubt on their salience and may indicate that other neighborhood features are more strongly associated with these outcomes.

13.
Artigo em Inglês | MEDLINE | ID: mdl-33318134

RESUMO

BACKGROUND: Efforts to reduce socioeconomic inequities in cardiovascular disease include interventions to change the built environment. We aimed to explore whether socioeconomic inequities in coronary heart disease (CHD) incidence are ameliorated or exacerbated in environments supportive of physical activity (PA). METHODS: We used data from the Reasons for Geographic and Racial Differences in Stroke study, which recruited US residents aged 45 or older between 2003 and 2007. Our analyses included participants at risk for incident CHD (n=20 808), followed until 31 December 2014. We categorised household income and treated it as ordinal: (1) US$75 000+, (2) US$35 000-US$74 000, (3) US$20 000-US$34 000 and (4)

14.
JAMA Netw Open ; 3(5): e205105, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32412637

RESUMO

Importance: The association between proximity to health care facilities and improved disease management and population health has been documented, but little is known about small-area health care environments and how the presence of health care facilities has changed over time during recent health system and policy change. Objective: To examine geographic access to health care facilities across neighborhoods in the United States over a 15-year period. Design, Setting, and Participants: Using longitudinal business data from the National Establishment Time-Series, this cross-sectional study examined the presence of and change in ambulatory care facilities and pharmacies and drugstores in census tracts (CTs) throughout the continental United States between 2000 and 2014. Between January and April 2019, multinomial logistic regression was used to estimate associations between health care facility presence and neighborhood sociodemographic characteristics over time. Main Outcomes and Measures: Change in health care facility presence was measured as never present, lost, gained, or always present between 2000 and 2014. Neighborhood sociodemographic characteristics (ie, CTs) and their change over time were measured from US Census reports (2000 and 2010) and the American Community Survey (2008-2012). Results: Among 72 246 included CTs, the percentage of non-US-born residents, residents 75 years or older, poverty status, and population density increased, and 8.1% of CTs showed a change in the racial/ethnic composition of an area from predominantly non-Hispanic (NH) white to other racial/ethnic composition categories between 2000 and 2010. The presence of ambulatory care facilities increased from a mean (SD) of 7.7 (15.9) per CT in 2000 to 13.0 (22.9) per CT in 2014, and the presence of pharmacies and drugstores increased from a mean (SD) of 0.6 (1.0) per CT in 2000 to 0.9 (1.4) per CT in 2014. Census tracts with predominantly NH black individuals (adjusted odds ratio [aOR], 2.37; 95% CI, 2.03-2.77), Hispanic/Latino individuals (aOR 1.30; 95% CI, 1.00-1.69), and racially/ethnically mixed individuals (aOR, 1.53; 95% CI, 1.33-1.77) in 2000 had higher odds of losing health care facilities between 2000 and 2014 compared with CTs with predominantly NH white individuals, after controlling for other neighborhood characteristics. Census tracts of geographic areas with higher levels of poverty in 2000 also had higher odds of losing health care facilities between 2000 and 2014 (aOR, 1.12; 95% CI, 1.05-1.19). Conclusions and Relevance: Differential change was found in the presence of health care facilities across neighborhoods over time, indicating the need to monitor and address the spatial distribution of health care resources within the context of population health disparities.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Demografia , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estados Unidos
15.
Am J Public Health ; 110(3): 407-415, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31944851

RESUMO

Objectives. To characterize health and health-related resources in the new qualified opportunity zones (QOZs) relative to tracts not selected or not eligible for this federal investment incentive.Methods. We used tract-level data from the 498 largest cities in the contiguous United States (n = 24 409), categorized using designations from the Department of Treasury. We compiled data on population characteristics, health-related resources, and health from the American Community Survey, the National Establishment Time Series, the National Land Cover Dataset, and the US Small-Area Life Expectancy Estimates Project and the 500 Cities projects. We calculated means and SDs for ineligible, eligible (but not designated), and designated QOZ tracts.Results. In general, designated QOZ tracts had lower access to health care facilities, physical activity resources, and healthy food. They had a higher prevalence of unhealthy behaviors and worse health outcomes across most measures.Conclusions. By benchmarking conditions, we facilitate tracking and assessment of QOZ impacts.Public Health Implications. QOZ could spur unprecedented neighborhood change with substantial influence on health resources and outcomes. Public health collaboration and strategic local governance of QOZ will be crucial for yielding health benefits for existing residents.


Assuntos
Instalações de Saúde/estatística & dados numéricos , Recursos em Saúde/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Exercício Físico , Abastecimento de Alimentos , Comportamentos Relacionados com a Saúde , Humanos , Expectativa de Vida , Fatores Socioeconômicos , Estados Unidos
16.
J Transp Geogr ; 74: 91-96, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31548761

RESUMO

Background: Bike sharing systems have potential to substantially boost active transportation levels (and consequent physical and mental health) in urban populations. We explored equity of spatial access in a novel 'dockless' bike share system that does not that constrain bike pickup and drop-off locations to docking stations. Methods: Starting in July 2017, Seattle, Washington piloted a dockless bike share system that made 10,000 bikes available. We merged data on resident sociodemographic and economic characteristics from the American Community Survey about 93 defined neighborhoods with data about bike locations, bike idle time, and which neighborhoods operators rebalanced bikes to. We used mapping and descriptive statistics to compare access between neighborhoods along sociodemographic and economic lines. Results: With many bikes available, no neighborhood was consistently excluded from access. However, the average availability ranged from 3 bikes per day to 341 per day. Neighborhoods with more bikes had more college-educated residents (median 75% college-educated vs. 65%) and local community resources (median opportunity index score of 24 vs. 19), and higher incomes (median 83,202 vs. 71,296). Rebalancing destinations were strongly correlated with neighborhood demand (r=0.61). Conclusions: The overall scale of the dockless system ensured there was baseline access throughout Seattle. We observed modest inequities in access along sociodemographic lines, similar to prior findings in studies of docked bike share systems. Dockless bike share systems hold promise for offering equitable spatial access to bike sharing.

17.
J Urban Health ; 96(4): 570-582, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31037481

RESUMO

Efforts to increase physical activity have traditionally included either individual-level interventions (e.g., educational campaigns) or neighborhood-level interventions (e.g., additional recreational facilities). Little work has addressed the interaction between spatial proximity and individual characteristics related to facility use. We aimed to better understand the synergistic impact of both physical activity environments and recreational facility membership on objectively measured physical activity. Using the New York City Physical Activity and Transit (PAT) survey (n = 644), we evaluated associations between counts of commercial physical activity facilities within 1 km of participants' home addresses with both facility membership and accelerometry-measured physical activity. Individuals living near more facilities were more likely to report membership (adjusted odds ratio for top versus bottom quartile of facility count: 3.77 (95% CI 1.54-9.20). Additionally, while amount of facilities within a neighborhood was associated with more physical activity, this association was stronger for individuals reporting gym membership. Interventions aiming to increase physical activity should consider both neighborhood amenities and potential barriers, including the financial and social barriers of membership. Evaluation of neighborhood opportunities must expand beyond physical presence to consider multiple dimensions of accessibility.


Assuntos
Planejamento Ambiental/estatística & dados numéricos , Exercício Físico/psicologia , Recreação/psicologia , Características de Residência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque , Inquéritos e Questionários , Adulto Jovem
18.
Transp Rev ; 39(6): 706-732, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32981990

RESUMO

The deployment of smartphone-operated, non-station-based bicycle fleets ("dockless" or "free-floating" bikeshare) represents a new generation of bikesharing. Users locate bikes in these free-floating systems using Global Positioning Systems (GPS) and lock bikes in place at their destinations. In this paper, we review current free-floating bikesharing systems in North America and discuss priorities for future research and practice. Since launching in 2017, free-floating bikeshare has expanded rapidly to encompass 200+ systems operating 40,000+ bikes within 150+ cities. In contrast with previous systems, free-floating systems operate almost exclusively using commercial "for-profit" models, amidst concerns of financial sustainability. Governance for these systems is in early stages and can include operating fees, fleet size caps, safety requirements, parking restrictions, data sharing, and equity obligations. We identify research and practice gaps within the themes of usage, equity, sharing resources, business model, and context. While some existing bikesharing literature translates to free-floating systems, novel topics arise due to the ubiquity, fluidity, and business models of these new systems. Systems have numerous obstacles to overcome for long-term sustainability, including barriers common to station-based systems: limited supportive infrastructure, equity, theft or vandalism, and funding. Other unique obstacles arise in free-floating bikeshare around parking, sidewalk right of ways, varied bicycle types, and data sharing. This review offers background in and critical reflection on the rapidly evolving free-floating bikeshare landscape, including priorities for future research and practice. If concerns can be overcome, free-floating bikeshare may provide unprecedented opportunities to bypass congested streets, encourage physical activity, and support urban sustainability.

19.
Prev Med Rep ; 11: 312-313, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30210997

RESUMO

[This corrects the article DOI: 10.1016/j.pmedr.2018.03.008.].

20.
Prev Med Rep ; 10: 184-190, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29868365

RESUMO

New rapid transit investments have been motivated by environmental, economic, and health benefits. Given transit's potential to increase active travel, recent research leverages transit changes for natural experiment studies to examine physical activity outcomes. We aimed to quantify the association size, critically examine existing literature, and make recommendations for future studies to advance research and policies on active travel, transportation, and physical activity. Studies of physical activity impacts following transit interventions were systematically reviewed using seven health and transport databases (May-July 2017). Two investigators extracted data on sample size, intervention, pre- and post-intervention physical activity, and relevant measurement information. Inconsistency of results and estimated overall mean physical activity change post-intervention were assessed. Forest plots were created from physical activity change in each study using a general variance-based random effects model. Of 18 peer-reviewed articles examining health behaviors, 15 addressed physical activity and five were natural experiment studies with pre- and post- intervention measurements. Studies varied by intervention, duration, outcome measurement, sampling location, and spatial method. Q (201) and I2 (98%) indicated high study heterogeneity. Among these five studies, after transit interventions, total physical activity decreased (combined mean - 80.4 min/week, 95% CI - 157.9, -2.9), but transport-related physical activity increased (mean 6.7 min/week, 95% CI - 10.1, 23.5). Following new transit infrastructure, total physical activity may decline but transport-related physical activity may increase. Positive transit benefits were location, sociodemographic, or activity-specific. Future studies should address context, ensure adequate follow-up, utilize controls, and consider non-residential environments or participants.

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